Kevin J. Bozic, MD, MBA

Kevin J. Bozic, MD, MBA is William R. Murray Professor, M.D. Endowed Chair in Orthopaedic Surgery and Professor and Vice Chair of the Department of Orthopaedic Surgery and a member of the core faculty of the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco (UCSF). He is also a Visiting Scholar in the Institute for Strategy and Competitiveness at the Harvard Business School. Dr. Bozic is a graduate of the UCSF School of Medicine and the Harvard Combined Orthopaedic Residency Program. Additionally, he holds a Bachelor of Science degree in Biomedical Engineering from Duke University and a Masters of Business Administration from Harvard Business School. Dr. Bozic has fellowship training in Adult Reconstructive Surgery from Rush University Medical Center in Chicago.

Dr. Bozic’s clinical interests are in adult reconstructive surgery of the hip and knee, with an emphasis on primary and revision hip and knee replacement. His research interests are broadly in the fields of health policy and health care services research, and specifically in the areas of healthcare technology assessment, cost-effectiveness analysis, shared medical decision making, and the implementation and evaluation of value-based payment and delivery models. In addition to his clinical and research activities, Dr. Bozic is actively involved in numerous regional and national health policy initiatives, including the University of California Center for Health Quality and Innovation, the American Joint Replacement Registry, the Integrated Healthcare Association’s Episode of Care Payment Program, and the Institute for Healthcare Improvement/Harvard Business School’s collaborative Joint Replacement Learning Community.

Dr. Bozic also holds both regional and national leadership positions, member of the Board of Trustees of the Orthopaedic Research and Education Foundation, Chair of the American Academy of Orthopaedic Surgeons Council on Research and Quality, and Chair of the California Joint Replacement Registry.

Dr. Bozic has been the recipient of numerous awards and honors, including the Orthopaedic Research and Education Foundation’s Clinical Research Award, the American Academy of Orthopaedic Surgeon’s Clinician-Scientist Traveling Fellowship Award, the American Orthopaedic Association’s American-British-Canadian Traveling Fellowship, the American Association of Hip and Knee Surgeon’s James A. Rand Young Investigator Award, and the Orthopaedic Research Society’s William Harris Award.

Since arriving at UCSF, Dr. Bozic has received extramural funding for his research from the OREF, AHRQ, National Institutes of Health (NIH), Robert Wood Johnson Foundation (RWJF), the California HealthCare Foundation, and the University of California Center for Health Quality and Innovation.

Publications:

Variability in Costs Associated with Total Hip and Hip Knee Replacement Implants: Dr. Bozic and his collaborators at the University of California, Berkeley, Berkeley Center for Health Technology studies the patient, hospital, and market characteristic associated with variation in implant and total procedure costs for hip and knee arthroplasty. The results from their study found there are substantial variations in total hip replacement and total knee replacement implant costs within and across hospitals after controlling for patient diagnoses and comorbidities. This variation is responsible for the majority of variation in the overall cost of total hip and knee replacement surgery.

Patient-related risk factors for periprosthetic joint infection and postoperative mortality following total hip arthroplasty in Medicare patients: Dr. Bozic and the Multi Total Joint Arthroplasty Health Services Research Group studied the specific patient comorbidities associated with an increased risk of periprosthetic joint infection and of ninety-day postoperative mortality in U.S. Medicare patients undergoing total hip arthroplasty. Comorbid conditions associated with an increased risk of periprosthetic joint infection in Medicare patients who under total hip arthroplasty included were rheumatologic disease, obesity, coagulopathy, and preoperative anemia. Comorbid conditions associated with an increase adjusted risk of ninety-day postoperative mortality were congestive heart failure, metastatic cancer, pyschoses, renal disease, dementia, hemiplegia or paraplegia, cerebrovascular disease, and chronic pulmonary disease. This information is important when counseling elderly patients regarding the risks of periprosthetic joint infection and mortality following total hip arthroplasty, as well as for risk adjustment of publicly reported total hip arthroplasty outcomes.

The Impact of Direct-to-Consumer Advertising in Orthopaedics: Dr. Bozic and his colleagues received the 2007 ABJS Marshall Urist Award for their work entitled “The Impact of Direct-to-consumer advertising in Orthopaedic.” This study evaluated the influence of direct-to-consumer advertising on surgeon and patient opinions and behavior in orthopaedics by surveying orthopaedic surgeons who perform hip and knee arthroplasties and patients who were scheduled to have hip or knee arthroplasty. Based on his research findings, Dr. Bozic was invited to testify on behalf of the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Hip and Knee Surgeons (AAHKS) at a Senate Special Committee on Aging hearing on medical device direct-to-consumer advertising to express concern over the direct-to-consumer advertising (DTCA) of restricted medical products. Also on behalf of AAOS and AAHKS, Dr. Bozic offered specific recommendations to the Committee as it examines the consequences of the DTCA of medical devices.

The Role for Aspirin in Venous Thromboembolism Prophylaxis After Total Knee Replacement: Dr. Bozic colleagues received the 2007 James. Rand Award for their study entitled “Is There a Role for Aspirin in Venous Thromboembolism Prophylaxis After Total Knee Replacement?” Dr. Bozic and colleagues compared the risk of venous thromboembolism (VTE), bleeding, surgical site infection, and mortality in patients receiving aspirin or guideline approved VTE prophylactic therapies (warfarin, low-molecular weight, heparins, synthetic pentasaccharides) in total knee arthroplasty (TKA). The results suggest that aspirin, when used in conjunction with other clinical care protocols, may be effective against VTEP for certain TKA patients. The findings from this study have been used by policy makers when developing clinical practice guidelines for TKA patients.

Epidemiology of Total Joint Replacement Using Administrative Data: The American Association of Hip and Knee Surgeons honored Dr. Bozic with the 2008 Lawrence D. Dorr Award on his study “The Epidemiology of Revision Total Hip Arthroplasty in the United States,” which evaluated the mechanisms of failure and the types of revision total hip arthroplasty procedures performed in the United States with use of newly implemented ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis and procedure codes specifically to revision total hip arthroplasty in a large, nationally representative population. Dr. Bozic and his colleagues have done extensive research over the past 3 years using these new administrative codes to evaluate causes of failure in both hip and knee replacement patients. This type of information is proving increasing valuable in directing research objectives, implant design, and clinical decision making.

The Impact of Volume and Adherence to Evidence Based Practice Guidelines on Quality and Cost in Orthopaedic Surgery: The Orthopaedic Research Society (ORS) honored Dr. Bozic with the 2010 William Harris Award for his work entitled “The Influence of Procedure Volumes and Adherence to Evidence-Based Processes of Care on Quality and Efficiency in Total Joint Arthroplasty.” This study evaluated the independent contributions of surgeon procedure volume, hospital procedure volume, and standardization of care on short-term post-operative outcomes and resource utilization in lower extremity total joint arthroplasty. The findings from this study indicated that hospitals and surgeons who adhere to standardized processes of care have improved total joint arthroplasty patient outcomes, independent of hospital and surgeon procedure volume.

Selected Projects:

Shared Decision Making and Patient Engagement in Orthopaedic SurgeryIdentification of Risk Factors for Revision Surgery Following Primary THA and TKAIntegrated Care Delivery and Episode of Care Payments in Hip and Knee ArthroplastyThe Impact of Reference Pricing on Cost and Quality in Orthopaedics